Coverage of birth control under new health care law still in question

By Hilarie Meyers, Development and Communications Intern

As the buzz around midterm elections begins to die down, it’s time to revisit a topic that preoccupied NLIRH earlier in the year, contraception and health care reform.

First, let’s quickly review the facts and events leading up to today’s discussion.  During the Senate’s debates over health care reform, Senator Barbara Mikulski (D-Maryland) introduced the Women’s Health Amendment, which she authored with the intention of increasing women’s access to preventative care, including family planning and contraception. Despite opposition from both Republicans and members of her own party, Senator Mikulski fought hard and was ultimately successful: the Women’s Health Amendment was included in the health care reform legislation passed by Congress in March.  The Department of Health and Human Services has already released a list of preventative care services that will be covered 100% under the new law, meaning no cost to consumers.  This list includes many preventive care services essential to ensuring women’s wellbeing. However, in spite of the explicit intentions of the Women’s Health Amendment, birth control has so far been left off of the list’s provisions.

Starting on November 16, a panel will meet to further discuss what medicines and services will count as preventative care under the new law.  At this point in time, it remains unclear whether or not birth control will make the list.  Undoubtedly, the answer to this question will have huge implications for women across the country.  If the panel chooses to categorize birth control as a form of preventative medicine, certain contraceptives, such as the pill, would be available at no cost to consumers. However, if the panel does not categorize birth control as preventative medicine, many women will have to choose whether to continue paying high and often unaffordable prices for birth control or to forgo the use of such contraceptives altogether.  

The question of whether or not birth control should be regarded as preventive medicine may seem like it has an easy answer.  After all, birth control prevents unplanned pregnancies.  However, as we’ve seen, discussions about reproductive health care are never as simple as they seem.  In his article, “Free Birth Control: Health Care Overhaul May Provide Pill as Preventative Medicine,” Ricardo Alonso-Zaldivar, summarizes the opposition, writing:

U.S. Catholic bishops say pregnancy is a healthy condition, not an illness… “We don’t consider it to be health care, but a lifestyle choice,” said John Haas, president of the National Catholic Bioethics Center, a Philadelphia think tank whose work reflects church teachings. “We think there are other ways to avoid having children than by ingesting chemicals paid for by health insurance.”

However, the argument that birth control should be categorized as preventative medicine is not based on the assumption that pregnancy is an illness or disease.  Rather, it is predicated on the realization that pregnancies affect the health outcomes and wellbeing of women, men, children, and communities.  In her article, “Health Insurers May Soon Offer Contraceptives at No Extra Cost,” Michelle Andrews explains:

Among other health benefits, women who plan their pregnancies are more likely to get necessary prenatal care and avoid closely spaced births, which can put a strain on their bodies and their parenting skills, and may result in low-birth-weight babies…Improving access and coverage even further could help reduce the estimated 3 million pregnancies a year that are unplanned…One of the reasons for unintended pregnancies is the cost of contraception, say experts.

Ultimately, by making birth control affordable and accessible (read: free), we could lower the number of unplanned pregnancies and abortions, while simultaneously improving our country’s health.

The introduction of the birth control pill was revolutionary in that it empowered many women to take control of their bodies, health, and lives into their own hands.  However, there are still plenty of women who lack access to and/or can’t afford reliable contraceptives.  This component of health care reform would make birth control more accessible to women everywhere, particularly Latinas, who are more likely to be uninsured than women of any other ethnic or racial group and are also disproportionately living in poverty.  By making birth control more accessible, health care reform also may reduce the persisting stigmas that deter women from seeking out birth control in the first place, as well as potentially pave the way for other birth control options, such as IUD’s and even Plan-B, to gain greater acceptability and visibility in the United States.

By Hilarie Meyers, Development and Communications Intern

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